title: Health care professionals' pain narratives in hospitalized children's medical records. Part 1: pain descriptors.
abstract: BACKGROUND
  Although documentation of children's pain by health care professionals is frequently undertaken, few studies have explored the nature of the language used to describe pain in the medical records of hospitalized children.
  
  
  OBJECTIVE
  To describe health care professionals' use of written language related to the quality and quantity of pain experienced by hospitalized children.
  
  
  METHODS
  Free-text pain narratives documented during a 24 h period were collected from the medical records of 3822 children (0 to 18 years of age) hospitalized on 32 inpatient units in eight Canadian pediatric hospitals. A qualitative descriptive exploration using a content analysis approach was used.
  
  
  RESULTS
  Pain narratives were documented a total of 5390 times in 1518&nbsp;of the 3822 children's medical records (40%). Overall, word choices represented objective and subjective descriptors. Two major categories were identified, with their respective subcategories of word indicators and associated cues: indicators of pain, including behavioural (e.g., vocal, motor, facial and activities cues), affective and physiological cues, and children's descriptors; and word qualifiers, including intensity, comparator and temporal qualifiers.
  
  
  CONCLUSIONS
  The richness and complexity of vocabulary used by clinicians to document children's pain lend support to the concept that the word 'pain' is a label that represents a myriad of different experiences. There is potential to refine pediatric pain assessment measures to be inclusive of other cues used to identify children's pain. The results enhance the discussion concerning the development of standardized nomenclature. Further research is warranted to determine whether there is congruence in interpretation across time, place and individuals.
authors.forename: Judy
authors.initials: J
authors.lastname: Rashotte
authors.forename: Geraldine
authors.initials: G
authors.lastname: Coburn
authors.forename: Denise
authors.initials: D
authors.lastname: Harrison
authors.forename: Bonnie J
authors.initials: BJ
authors.lastname: Stevens
authors.forename: Janet
authors.initials: J
authors.lastname: Yamada
authors.forename: Laura K
authors.initials: LK
authors.lastname: Abbott
mesh_terms: D000293:Adolescent; D002648:Child; D002673:Child, Hospitalized / Q000706:statistics & numerical data; D002675:Child, Preschool; D004282:Documentation; D005260:Female; D006282:Health Personnel; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007802:Language; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data; D010146:Pain; D010372:Pediatrics